Clinical dissection of multicentric Castleman disease

Abstract

This study investigated the prognostic factors of Castleman disease (CD) and focused specifically on multicentric CD (MCD). Seventy patients with CD were studied. Forty-three patients (61.5%) had unicentric CD (UCD) and 27 patients (38.5%) had MCD. Thirty-six patients with UCD (83.7%) underwent surgical excision, and 25 patients with MCD (92.6%) received systemic treatment, including corticosteroids and combination chemotherapy. In the patients with MCD, age >60 years and the presence of splenomegaly were prognostic factors for progression-free survival (hazard ratio [HR] 9.01, 95% confidence interval [CI] 2.64-30.83 and HR 4.32, 95% CI 1.16-16.09) as well as overall survival (OS) in MCD (HR 8.7, 95% CI 2.83-26.84 and HR 2.9, 95% CI 0.95-9.02, respectively). Patients <= 60 years old without splenomegaly showed better OS than patients >60 years old or with splenomegaly (71.4% vs. 10.8% for 5-year OS). MCD might be dissected clinically by the simple parameters of age and presence of splenomegaly.